Summary of evidence that the foreskin
and
lysozyme may protect against HIV infection

By George Hill

This file contains a summary of the evidence
that the foreskin and the sub-preputial wetness under the
foreskin (prepuce) may protect against human immunodeficiency
virus (HIV). This brief review of the evidence does not
pretend to be a balanced presentation.

Lysozyme is an enzyme with anti-bacterial action that is
found in body fluids. (An enzyme is a protein or conjugated
protein produced by a living organism and functions as a
biochemical catalyst.1 Lysozyme
breaks down cell walls and kills bacteria.

Laumann et al.
report that about 77 percent of adult American males are
circumcised. 4 Thus, these
circumcised males have no sub-preputial wetness and no
lysozyme protection. Laumann finds that circumcised men are
slightly more likely to have both a bacterial and a viral STD
in their lifetime.4

World Health Organization data show that the incidence of
HIV infection in the United States is four or more times
greater than in any other advanced industrial nation.5 Other advanced nations either do not
circumcise males or have a very low incidence of circumcision
compared to the United States.6

Chao reports that
a circumcised husband is a risk factor for HIV infection
amongst pregnant women in Rwanda.7Grosskurth et al.
find a higher incidence of HIV infection in circumcised men
in Tanzania.8

The high incidence of HIV in the United States and its
correlation with the high rate of circumcision has been noted
by Storms9 and Nicoll.10 Furthermore, Tanne
reports a general epidemic of STD, including chlamydia and
HIV, in the United States.11

Moreover, Fleiss
and others report that the increased friction and more
vigorous and prolonged thrusting required to achieve orgasm
with a circumcised penis may be more likely to cause "breaks,
tears, microfissures, abrasions, and lacerations through
which HIV in semen can enter the receiving partner's
bloodstream."12

Van Howe performed a statistical meta-analysis of the raw
data from the African HIV literature. His analysis revealed
that circumcised men are more likely to be HIV
infected.13,14

More research is needed to verify the protective effect of
lysozyme and the foreskin in vivo.

References

The American
Heritage Dictionary of the English Language, 3rd
edition. Houghton Mifflin Company, Boston: 1992.